If someone’s heart suddenly stops beating, they may only have minutes to live. Doing CPR (cardiopulmonary resusciation) can increase their chances of survival. CPR makes sure blood keeps pumping, providing oxygen to the brain and vital organs until specialist treatment arrives.

But research shows bystanders are less likely to intervene to perform CPR when that person is a woman. A recent Australian study analysed 4,491 cardiac arrests between 2017–19 and found bystanders were more likely to give CPR to men (74%) than women (65%).

Could this partly be because CPR training dummies (known as manikins) don’t have breasts? Our new research looked at manikins available worldwide to train people in performing CPR and found 95% are flat-chested.

Anatomically, breasts don’t change CPR technique. But they may influence whether people attempt it – and hesitation in these crucial moments could mean the difference between life and death.

Heart health disparities

Cardiovascular diseases – including heart disease, stroke and cardiac arrest – are the leading cause of death for women across the world.

But if a woman has a cardiac arrest outside hospital (meaning her heart stops pumping properly), she is 10% less likely to receive CPR than a man. Women are also less likely to survive CPR and more likely to have brain damage following cardiac arrests.

These are just some of many unequal health outcomes women experience, along with transgender and non-binary people. Compared to men, their symptoms are more likely to be dismissed or misdiagnosed, or it may take longer for them to receive a diagnosis.

Bystander reluctance

There is also increasing evidence women are less likely to receive CPR compared to men.

This may be partly due to bystander concerns they’ll be accused of sexual harassment, worry they might cause damage (in some cases based on a perception women are more “frail”) and discomfort about touching a woman’s breast.

Bystanders may also have trouble recognising a woman is experiencing a cardiac arrest.

Even in simulations of scenarios, researchers have found those who intervened were less likely to remove a woman’s clothing to prepare for resuscitation, compared to men. And women were less likely to receive CPR or defibrillation (an electric charge to restart the heart) – even when the training was an online game that didn’t involve touching anyone.

There is evidence that how people act in resuscitation training scenarios mirrors what they do in real emergencies. This means it’s vital to train people to recognise a cardiac arrest and be prepared to intervene, across genders and body types.

Skewed to male bodies

Most CPR training resources feature male bodies, or don’t specify a sex. If the bodies don’t have breasts, it implies a male default.

For example, a 2022 study looking at CPR training across North, Central and South America, found most manikins available were white (88%), male (94%) and lean (99%).

These studies reflect what we see in our own work, training other health practitioners to do CPR. We have noticed all the manikins available to for training are flat-chested. One of us (Rebecca) found it difficult to find any training manikins with breasts.

A single manikin with breasts

Our new research investigated what CPR manikins are available and how diverse they are. We identified 20 CPR manikins on the global market in 2023. Manikins are usually a torso with a head and no arms.

Of the 20 available, five (25%) were sold as “female” – but only one of these had breasts. That means 95% of available CPR training manikins were flat-chested.

We also looked at other features of diversity, including skin tone and larger bodies. We found 65% had more than one skin tone available, but just one was a larger size body. More research is needed on how these aspects affect bystanders in giving CPR.

Breasts don’t change CPR technique

CPR technique doesn’t change when someone has breasts. The barriers are cultural. And while you might feel uncomfortable, starting CPR as soon as possible could save a life.

Signs someone might need CPR include not breathing properly or at all, or not responding to you.

To perform effective CPR, you should:

• put the heel of your hand on the middle of their chest
• put your other hand on the top of the first hand, and interlock fingers (keep your arms straight)
• press down hard, to a depth of about 5cm before releasing
• push the chest at a rate of 100-120 beats per minute (you can sing a song) in your head to help keep time!)

https://www.youtube.com/embed/Plse2FOkV4Q?wmode=transparent&start=94 An example of how to do CPR – with a flat-chested manikin.

What about a defibrillator?

You don’t need to remove someone’s bra to perform CPR. But you may need to if a defibrillator is required.

A defibrillator is a device that applies an electric charge to restore the heartbeat. A bra with an underwire could cause a slight burn to the skin when the debrillator’s pads apply the electric charge. But if you can’t remove the bra, don’t let it delay care.

What should change?

Our research highlights the need for a range of CPR training manikins with breasts, as well as different body sizes.

Training resources need to better prepare people to intervene and perform CPR on people with breasts. We also need greater education about women’s risk of getting and dying from heart-related diseases.

Jessica Stokes-Parish, Assistant Professor in Medicine, Bond University and Rebecca A. Szabo, Honorary Senior Lecturer in Critical Care and Obstetrics, Gynaecology and Newborn Health, The University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

At this time of year many of us resolve to prioritise our health. So it is no surprise there’s a roaring trade of products purporting to guarantee you live longer, be healthier and look more youthful.

While an estimated 25% of longevity is determined by our genes, the rest is determined by what we do, day to day.

There are no quick fixes or short cuts to living longer and healthier lives, but the science is clear on the key principles. Here are five things you can do to extend your lifespan and improve your health.

1. Eat a predominantly plant-based diet

What you eat has a huge impact on your health. The evidence overwhelmingly shows eating a diet high in plant-based foods is associated with health and longevity.

If you eat more plant-based foods and less meat, processed foods, sugar and salt, you reduce your risk of a range of illnesses that shorten our lives, including heart disease and cancer.

Plant-based foods are rich in nutrients, phytochemicals, antioxidants and fibre. They’re also anti-inflammatory. All of this protects against damage to our cells as we age, which helps prevent disease.

No particular diet is right for everyone but one of the most studied and healthiest is the Mediterranean diet. It’s based on the eating patterns of people who live in countries around the Mediterranean Sea and emphases vegetables, fruits, wholegrains, legumes, nuts and seeds, fish and seafood, and olive oil.

2. Aim for a healthy weight

Another important way you can be healthier is to try and achieve a healthy weight, as obesity increases the risk of a number of health problems that shorten our lives.

Obesity puts strain on all of our body systems and has a whole myriad of physiological effects including causing inflammation and hormonal disturbances. These increase your chances of a number of diseases, including heart disease, stroke, high blood pressure, diabetes and a number of cancers.

In addition to affecting us physically, obesity is also associated with poorer psychological health. It’s linked to depression, low self-esteem and stress.

One of the biggest challenges we face in the developed world is that we live in an environment that promotes obesity. The ubiquitous marketing and the easy availability of high-calorie foods our bodies are hard-wired to crave mean it’s easy to consume too many calories.

3. Exercise regularly

We all know that exercise is good for us – the most common resolution we make this time of year is to do more exercise and to get fitter. Regular exercise protects against chronic illness, lowers your stress and improves your mental health.

While one of the ways exercising helps you is by supporting you to control your weight and lowering your body fat levels, the effects are broader and include improving your glucose (blood sugar) use, lowering your blood pressure, reducing inflammation and improving blood flow and heart function.

While it’s easy to get caught up in all of the hype about different exercise strategies, the evidence suggests that any way you can include physical activity in your day has health benefits. You don’t have to run marathons or go to the gym for hours every day. Build movement into your day in any way that you can and do things that you enjoy.

4. Don’t smoke

If you want to be healthier and live longer then don’t smoke or vape.

Smoking cigarettes affects almost every organ in the body and is associated with both a shorter and lower quality of life. There is no safe level of smoking – every cigarette increases your chances of developing a range of cancers, heart disease and diabetes.

Even if you have been smoking for years, by giving up smoking at any age you can experience health benefits almost immediately, and you can reverse many of the harmful effects of smoking.

If you’re thinking of switching to vapes as a healthy long term option, think again. The long term health effects of vaping are not fully understood and they come with their own health risks.

5. Prioritise social connection

When we talk about living healthier and longer, we tend to focus on what we do to our physical bodies. But one of the most important discoveries over the past decade has been the recognition of the importance of spiritual and psychological health.

People who are lonely and socially isolated have a much higher risk of dying early and are more likely to suffer from heart disease, stroke, dementia as well as anxiety and depression.

Although we don’t fully understand the mechanisms, it’s likely due to both behavioural and biological factors. While people who are more socially connected are more likely to engage in healthy behaviours, there also seems to be a more direct physiological effect of loneliness on the body.

So if you want to be healthier and live longer, build and maintain your connections to others.

Hassan Vally, Associate Professor, Epidemiology, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.